| 摘要: |
| 目的：本研究旨在分析Rh血型系统主要抗原表现型的分布情况，并评估Rh血型系统同抗原或少抗原输注在反复输血患者中的疗效与安全性。方法：选取本院2022年5月-2023年12月在我院住院患者血标本32256份，健康献血员12386份，健康体检者血液标本19870份，选取同一时间段需要反复输血的患者166例，按是否实行Rh分型同型输血分组，其中未实施Rh分型同型输血为对照组（n=83），实施Rh分型同型输血为实验组（n=83）。采用Rh血型抗原检测卡利用全自动血型分析仪检测并记录患者和献血员的Rh血型，将信息输入到输血科的计算机系统中，建立Rh血型数据库，系统自行配对；对比两组患者输注效果评价；对比两组患者输血前后疗效指标[血红蛋白（Hb）、红细胞压积（HCT）]；对比两组患者输血后不良反应发生率。结果：在32256例住院患者Rh抗原表现型分布规律为CCDee（41.91%）、CcDEe（36.49%）占比最大，CCDEE（0.06%）占比最小，在12256例健康体检者和献血员Rh抗原表现型分布规律为CCDee（42.72%）、CcDEe（33.37%）占比最大，CCDEE（0%）占比最小。住院患者Rh血型C、c、D、E、e抗原频率与健康体检者和献血员比较，差异无统计学意义（P>0.05）；且住院患者Rh血型C、c、D、E、e基因频率与健康体检者和献血员比较，差异无统计学意义（P>0.05）。与对照组相比，实验组平均输注红细胞量降低，实验组有效输注率（72.29%）显著高于对照组（51.81%），且实验组Rh系统抗体阳性率显著低于对照组（P<0.05）。与治疗前相比，输血后两组患者Hb、HCT水平均升高，且实验组上述指标优于对照组（P<0.05）。实验组输血反应发生率（6.02%）显著低于对照组输血反应发生率（15.66%）（P<0.05）。结论：Rh血型抗原分型和Rh血型系统同抗原或少抗原输注的应用有效降低意外抗体阳性发生率，提高输血治疗的效果，保证患者的治疗安全。 |
| 关键词: 输血 Rh血型系统 血型抗原 不良反应 |
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| The distribution of major antigen phenotypes of Rh blood group system and the efficacy and safety of Rh blood group system with or without antigen infusion in patients with repeated blood transfusion |
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Liu Zhenxian1,2,3, Pan Xiaoliang1,2,3, Liang Qiaomi1,2,3
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1.Hangzhou First People'2.'3.s Hospital
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| Abstract: |
| Objective: This study aims to analyze the distribution of major antigen phenotypes in the Rh blood group system and evaluate the efficacy and safety of Rh blood group system with same or less antigen infusion. Method: 32256 blood samples from hospitalized patients, 12386 healthy blood donors, and 19870 blood samples from healthy examinees were selected from our hospital from May 2022 to December 2023. 166 patients who required repeated blood transfusions during the same period were divided into two groups based on whether they received Rh typing and transfusion. The control group (n=83) did not receive Rh typing and transfusion, while the experimental group (n=83) received Rh typing and transfusion. Rh blood types of patients and blood donors were detected and recorded by Rh blood group antigen detection card using fully automatic blood type analyzer, and the information was input into the computer system of the blood transfusion department to establish Rh blood type database, and the system matched itself; Compare the infusion effect evaluation between two groups of patients; Compare the efficacy indicators of hemoglobin (Hb) and hematocrit (HCT) between two groups of patients before and after blood transfusion; Compare the incidence of adverse reactions after blood transfusion between two groups of patients. Result: The distribution pattern of Rh antigen phenotype in 32256 hospitalized patients showed that CCDee (41.91%) and CcDEe (36.49%) accounted for the largest proportion, while CCDee (0.06%) accounted for the smallest proportion. In 12256 healthy individuals and blood donors, the distribution pattern of Rh antigen phenotype was CCDee (42.72%) and CcDEe (33.37%) accounted for the largest proportion, while CCDee (0%) accounted for the smallest proportion. There was no statistically significant difference in the frequency of Rh blood type C, c, D, E, and e antigens between hospitalized patients and healthy individuals undergoing physical examinations and blood donors (P>0.05); There was no statistically significant difference in the frequency of Rh blood group C, c, D, E, and e genes between hospitalized patients and healthy individuals and blood donors (P>0.05). Compared with the control group, the average amount of red blood cells infused in the experimental group decreased. The effective infusion rate in the experimental group (72.29%) was significantly higher than that in the control group (51.81%), and the Rh system antibody positivity rate in the experimental group was significantly lower than that in the control group (P<0.05). Compared with before treatment, the Hb and HCT levels of both groups of patients increased after blood transfusion, and the above indicators in the experimental group were better than those in the control group (P<0.05). The incidence of transfusion reactions in the experimental group (6.02%) was significantly lower than that in the control group (15.66%) (P<0.05). Conclusion: The application of Rh blood group antigen typing and Rh blood group system same antigen or few antigen infusion effectively reduces the incidence of accidental antibody positivity, improves the effectiveness of transfusion therapy, and ensures the safety of patient treatment. |
| Key words: Blood transfusion Rh blood type system Blood type antigen Adverse reactions |